Ultrasound, leg veins (duplex)
Facility: Ellinwood District Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $441
- Cash Discount Price: $536
- vs. Medicare Baseline: 1.81x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $243.77 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $441 | 181% |
| Humana | $441 | 181% |
| Cigna | $441 | 181% |
| Blue Cross Blue Shield | $441 | 181% |
| UnitedHealthcare | $441 | 181% |
Consumer Guidance & Cost Commentary
For this ultrasound of the leg veins at Ellinwood District Hospital, the facility's negotiated rate is $441, which matches the median paid across all five major payers including Aetna, Humana, and Cigna. This negotiated amount is significantly higher than the cash price of $536, meaning patients paying out-of-pocket directly could save money if they qualify for a cash discount. While the facility is a Critical Access Hospital in Ellinwood, KS, the data does not provide specific county or state average comparisons for this procedure, so the $441 negotiated rate serves as the primary benchmark for in-network members.
The Medicare benchmark for this service is $243.77, indicating that the commercial negotiated rate represents a markup of 1.8 times the Medicare amount. Because the negotiated rate exceeds the cash price, patients with high-deductible plans may find it financially advantageous to pay the cash price directly, provided they secure a prompt-pay discount from the hospital. To maximize savings, patients should request a self-pay classification before scheduling and explicitly ask for a prompt-pay discount, which can reduce the bill by 20% to 50% if paid in full upfront. It is also important to verify that no balance billing will occur, as the No Surprises Act protects patients from unexpected out-of-network charges at in-network facilities.